SOW Att 01_Appointment of Security Representative Template 496.docx

DOCX document 101 KB Posted

Attached to
Tinker AFB MAC BOA - WWYK240176 - Replace Industrial Waste Lift Stations 6N & 6S, B62501
Solicitation number
FA813726R0043
Issued by

About this file

This is a template memorandum for appointment of security representatives at Tinker Air Force Base. The document serves as a formal authorization letter that designates contractor personnel as Security Representatives for a specific contract, enabling them to sign AFMC Form 496 as requesting officials, designate sponsorship and escorts, and bypass the requirement for a DD Form 577 on file. The template includes fields for contract number, validity dates (from and to), and a roster of up to six personnel with rank, name, and signature lines. The memorandum is directed to the 72 Security Forces Visitor Control Center from the 72 ABW/CENM office and must be signed by the Government Contracting Officer's Representative (COR) or Discipline Engineer from the 72d Civil Engineering Directorate.

This template document is designed for use with the Tinker AFB MAC BOA contract FA813726R0043 (WWYK240176 - Replace Industrial Waste Lift Stations 6N & 6S, B62501) and establishes the administrative process for streamlining base access and visitor control procedures for designated contractor representatives. The memorandum supersedes all previous security representative appointment letters and requires the Government POC/COR contact information to be included for any questions regarding the designations.

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Text version

DEPARTMENT OF THE AIR FORCE

HEADQUARTERS 72 AIR BASE WING (AFMC)

TINKER AIR FORCE BASE OKLAHOMA

MEMORANDUM FOR 72 SECURITY FORCES VISITOR CONTROL CENTER

FROM: 72 ABW/CENM – Company Name

SUBJECT: Appointment of Security Representatives

1. The listed personnel below are hereby designated as Security Representatives for COMPANY, contract #XXXXXXXXXXXXXX, valid from DD MMM YYYY to DD MMM YYYY; they are authorized to sign AFMC Form 496 as requesting officials/designate sponsorship/escorts and will not require a DD Form 577 on file.

P/A
Rank/Last, First MI
SIGNATURE
P
LAST, FIRST M.
A
LAST, FIRST M.
A
LAST, FIRST M.
A
LAST, FIRST M.
A
LAST, FIRST M.

2. This letter supersedes all previous letters, same subject. If you have any questions, please contact Government POC/COR at phone number.

COR NAME
Discipline Engineer/COR
72d Civil Engineering Directorate

cc:

72ABW/CEEN/CEED (Tepa Companies)

AFSC/PZIOC

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